Central Massachusetts Physical Therapy, host of the most recent Postural Respiration course, has a wonderful clinic culture. Its clinicians provided an enthusiastic learning environment, where half of the attendees experienced a PRI course for the first time, and plenty of Dunkin Donuts coffee and bagels. Thank you to Mark Howard, Morgan Bronk, Brian Crowe, Micheal Curnen, Margret DiPlato, Connor Dougherty, Amanda Guavin-Valenta, Robyn Hillard, Tarandeep “TJ” Jaidka, Katherine Jones, Chloe Lal, Donna Layman, Megan McGuiness, Connor McLaughlin, Matthew McLeod, and David Urella for your efforts in set-up, take down, tech support, food, and interest in the science of PRI.
Attendees of various backgrounds (PT, OT, DC, PTA, massage, strength and conditioning) hailed from clinics with varied patient populations. That provided us an opportunity to touch upon the challenges inherent in patients with scoliosis, history of open heart surgery and stroke, and the movement maladies associated with advancing age.
I am very appreciative of all of the questions, comments, requests for review of concepts, and several “this is what I heard you say” moments. Thank you to those who elevated the learning experience for all by willing to be models for assessments and treatments: Morgan Bronk, Keith Donato, Gail Fennell, Jeanne Halloran, Jennifer Harris, Robyn Hillard, Rachel Medvedev, Alex Papanastassiou, Ruth Sunshine Wagner, Donna Waldrop, and Nathan Wright.
Thank you also to Tyler Tanaka, fellow PRC, for your help in explaining and demonstrating tests and techniques throughout the weekend. You and Michal Neidzielski, PRC, were so gracious to share your perspectives on certain concepts and patient application.
Postural Respiration takes a comprehensive look at the thoracic diaphragm anatomy and function, most-notably its role in providing compression and decompression, the origin of all movement. This course is lab-intensive, enabling attendees to achieve competence in performing objective tests and manual techniques and in coaching of non-manual techniques to prepare the attendee for Monday’s real-world patients.
Day one is devoted to understanding how our natural, normal human asymmetries drive us into patterned activity by overactive chains of muscles: namely the left AIC, right BC, and, in some individuals, the bilateral PEC. We learn first how to inhibit these chains of muscle, to disengage our patterned postures, and follow this with facilitation of under-sensed muscles that oppose and subdue the overactive chains. The result: a sense of the ground and compression through the left side of the body, a right rib cage that is free to expand, and a thorax that can flex to enable rotation to either side. Sounds like efficient walking, doesn’t it?
Day 2 is devoted to how to implement the treatment algorithm so that attendees can confidently apply the material. This includes significant lab time performing and interpreting tests and practicing non-manual and manual techniques. We also thoroughly define Superior T4 Syndrome, how it develops, its impact on movement, and how to treat it. Comments following non-manual technique practice included: “My neck tension is gone.” “I feel lighter.” “I don’t feel the impingement in my hip anymore.”
Throughout the weekend, we dissected numerous photos and videos of typical humans with typical jobs and hobbies, to answer these questions: How does hyperinflation restrict our movement from side to side? Why do we emphasize arm reaching in our techniques? How does arm reaching influence diaphragm position, thoracic flexion, and shifting of our COM when we walk, move? How does right arm reach differ from left arm reach in its effect on position and movement? How do the normal, natural asymmetries of the human species – i.e. a powerful thoracic diaphragm that has greater leverage on the right and a brain that has differing functions on the left and right – impact an individual who sits for a majority of the day, walks over hard, level surfaces, and rarely reaches with their arms? The answer: a high susceptibility to the head-to-toe syndromes that we treat.
Remember, the Institute is here to support you as you continue your PRI journeys. Please reach out with questions that arise. I’m looking forward to seeing all of you at future courses!
-Louise Kelley
